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用于男男性行为者甲基苯丙胺使用障碍的催产素强化动机性访谈团体治疗:一项随机对照试验的研究方案

Oxytocin-enhanced motivational interviewing group therapy for methamphetamine use disorder in men who have sex with men: study protocol for a randomized controlled trial.

作者信息

Stauffer Christopher S, Moschetto Jenna M, McKernan Scott M, Hsiang Elaine, Borsari Brian, Woolley Joshua D

机构信息

University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA, USA.

Palo Alto University, Palo Alto, CA, USA.

出版信息

Trials. 2019 Feb 21;20(1):145. doi: 10.1186/s13063-019-3225-7.

Abstract

BACKGROUND

The prevalence of methamphetamine use disorder (MUD) in the United States has risen dramatically in the past four decades and is concentrated in populations such as men who have sex with men (MSM). Despite the public health consequences of MUD, there are no FDA-approved psychopharmacological treatments. Psychosocial treatment alone has been shown to reduce methamphetamine use, but high attrition rates limit treatment efficacy. Promising findings from animal models of MUD using exogenous oxytocin, a social neuropeptide, have set the stage for translational work. Along with unique anti-addiction effects, oxytocin holds a primary role in enhancing social salience and modulating stress. In humans, oxytocin administration, combined with evidence-based psychosocial interventions, may act synergistically to improve addiction treatment outcomes and improve retention rates in current MUD treatment.

METHODS/DESIGN: We are conducting a randomized, double-blind, placebo-controlled trial of oxytocin-enhanced motivational interviewing group therapy (MIGT). Oxytocin or placebo 40 IU is administered intranasally in conjunction with six, weekly MIGT sessions. We will recruit 50 MSM, initiating treatment for MUD from specialized community health programs in San Francisco, CA, USA. Individuals will be randomized (1:1) to receive six, weekly sessions of MIGT with or without oxytocin. Our primary outcome is session attendance. Other outcomes of interest include: measures of group cohesion, anxiety, psychophysiology, and stimulant craving and use.

DISCUSSION

This will be the first study of oxytocin's effects in humans with MUD. Findings from this novel protocol will attempt to bridge existing animal data with the need for innovative clinical treatments for MUD, inform the growing field of pharmacologically-enhanced psychotherapy, and help to elucidate mechanisms behind oxytocin's potential anti-addiction effects.

TRIAL REGISTRATION

ClinicalTrials.gov, ID: NCT02881177 . Registered on 26 August 2016.

摘要

背景

在过去四十年中,美国甲基苯丙胺使用障碍(MUD)的患病率急剧上升,且集中在男男性行为者(MSM)等人群中。尽管MUD会带来公共卫生后果,但目前尚无美国食品药品监督管理局(FDA)批准的心理药物治疗方法。单独的心理社会治疗已被证明可减少甲基苯丙胺的使用,但高脱落率限制了治疗效果。使用外源性催产素(一种社会神经肽)进行的MUD动物模型研究取得了有前景的结果,为转化研究奠定了基础。除了独特的抗成瘾作用外,催产素在增强社会显著性和调节压力方面也起着主要作用。在人类中,催产素给药与循证心理社会干预相结合,可能会协同作用以改善成瘾治疗效果并提高当前MUD治疗的保留率。

方法/设计:我们正在进行一项关于催产素增强动机性访谈团体治疗(MIGT)的随机、双盲、安慰剂对照试验。将40国际单位的催产素或安慰剂通过鼻内给药,同时进行为期六周的每周一次的MIGT治疗。我们将招募50名MSM,他们将在美国加利福尼亚州旧金山的专门社区健康项目中开始接受MUD治疗。个体将被随机分配(1:1)接受为期六周的每周一次的有或没有催产素的MIGT治疗。我们的主要结局指标是治疗课程的出席率。其他感兴趣的结局指标包括:团体凝聚力、焦虑、心理生理学以及兴奋剂渴望和使用情况的测量。

讨论

这将是第一项关于催产素对患有MUD的人类影响的研究。这项新方案的研究结果将试图弥合现有的动物数据与对MUD创新临床治疗的需求之间的差距,为不断发展的药物增强心理治疗领域提供信息,并有助于阐明催产素潜在抗成瘾作用背后的机制。

试验注册

ClinicalTrials.gov,标识符:NCT0288​​1177。于2016年8月26日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f82/6385415/f310d2256aa4/13063_2019_3225_Fig1_HTML.jpg

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